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Prediction model for future OHCAs based on geospatial and demographic data: An observational study.

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High-risk areas for out-of-hospital cardiac arrest (OHCA) were identified using demographic data. These critical zones, comprising only 3.4% of Denmark, account for 65% of OHCA incidence, enabling targeted public health interventions.

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Area of Science:

  • Public Health
  • Epidemiology
  • Geographic Information Systems (GIS)

Background:

  • Out-of-hospital cardiac arrest (OHCA) is a major public health concern.
  • Effective prehospital preparedness requires accurate identification of high-risk areas.
  • Previous methods for identifying OHCA hotspots have limitations.

Purpose of the Study:

  • To develop and validate a novel prediction model for identifying high-risk areas of OHCA.
  • To inform targeted prehospital preparedness strategies and public health interventions.
  • To assess the spatial distribution and demographic correlates of OHCA incidence.

Main Methods:

  • Combined nationwide Danish Cardiac Arrest Registry data with hectare-level geographical and demographic data.
  • Classified hectares into hierarchical groups based on characteristics and pooled into square kilometers (km2).
  • Developed a prediction model incorporating historical OHCA incidence and predicted annual risk, validated against 19,090 OHCAs (2016-2019).

Main Results:

  • High OHCA incidence rates were observed in residential areas with high population density, pedestrian streets with shops, malls, public transport stations, and schools.
  • These identified high-risk areas constitute 3.4% of Denmark's total area but account for 65% of OHCA incidence.
  • The prediction model effectively identified future risk-sites, outperforming simple incidence-based methods.

Conclusions:

  • A small proportion of Denmark's area (3.4%) accounts for a disproportionately large share (65%) of OHCA events.
  • Demographic data and specific area characteristics (e.g., high population density, commercial zones, schools) are crucial for predicting OHCA risk.
  • Findings support targeted interventions, such as strategic placement of public-access automated external defibrillators (AEDs), informed by demographic data.